Detection of Surgical Wrap Defects in the Operating Room Setting
Abstract:
Surgical site infection is a challenging complication that places a significant burden on the patient and the health care system. Emphasis is being placed on the prevention and treatment of surgical site infections. We evaluated the accuracy of identifying surgical wrap defects based on defect size, location, and operating room staff experience. Forty sterilization wraps were divided into 4 separate groups based on the size of the puncture defects created. Defects measuring 1.2 mm, 3.7 mm, and 6.8 mm were compared with a control group of surgical wraps with no defects. Defects were randomly placed on an inner or outer line with circumference of 7 cm or 14 cm, respectively. Twenty operating room staff of varying levels of experience evaluated each wrap for defects. The detection rates for the 1.2-mm, 3.7-mm, and 6.8-mm wraps and the wraps with no defects were 3%, 73%, 80%, and 99%, respectively. A significant difference was seen between the detection rates for the small defects vs all other size defects. No significant difference was seen in detection rate based on the location of defects. The detection rate was higher among staff members with greater than 1 year of experience vs those with less than 1 year of experience. Sterilization wrap defects of all sizes went undetected at very high rates. Small defects of 1.2 mm, which have been shown to allow bacterial contamination, were missed 97% of the time. Operating room staff with more experience detected more defects than those with less than 1 year of experience. Wrap defects may be a source of bacterial contamination that may frequently go unnoticed. [Orthopedics. 2021;44(6):735-e738.].
Insights
Small sterilization wrap defects, even those allowing bacterial contamination, are frequently missed by operating room staff. Increased staff experience improves defect detection rates, highlighting a potential source of surgical site infections.
Area of Science:
- Healthcare
- Infection Control
- Medical Devices
Background:
- Surgical site infections (SSIs) pose a significant challenge to patient outcomes and healthcare systems.
- Preventing SSIs is a critical focus in healthcare settings.
- Sterilization wraps are essential for maintaining surgical instrument sterility.
Purpose of the Study:
- To evaluate the accuracy of identifying surgical wrap defects based on defect size, location, and operating room staff experience.
- To determine the detection rates of various defect sizes in sterilization wraps.
- To assess the impact of staff experience on defect detection.
Main Methods:
- Forty sterilization wraps with puncture defects of 1.2 mm, 3.7 mm, and 6.8 mm were created and compared to a control group with no defects.
- Defects were randomly placed on inner or outer circumference lines.
- Twenty operating room staff members with varying experience levels evaluated the wraps for defects.
Main Results:
- Detection rates for defects were 3% (1.2 mm), 73% (3.7 mm), and 80% (6.8 mm), compared to 99% for non-defective wraps.
- Small defects (1.2 mm) were missed 97% of the time.
- Operating room staff with over one year of experience had higher detection rates than those with less experience.
Conclusions:
- Sterilization wrap defects, particularly small ones, are frequently undetected, posing a risk for bacterial contamination.
- Defect location did not significantly impact detection rates.
- Enhancing staff training and awareness regarding sterilization wrap integrity is crucial for SSI prevention.
